Fundamentals of RPM: Sharing Personal Health Monitoring Data with Clinic of Choice and Guidance for Developers

May 21, 2020

By Thom Erickson, Director of Technical Standards, Personal Connected Health Alliance

We have described how Remote Patient Monitoring increases staff safety and reduces patient anxiety and how important this is at a very personal level as a very novel coronavirus spreads rapidly to everyone in every corner of the world. We have promoted interoperability over connectivity to empower the patient with more choices to monitor their own health. We have shared with managers who are working rapidly to develop devices insight into how leading standards provide information critical to clinical decisions.

Now that we have collected this critical health data, how do we ensure that nothing is lost as it is transported from any sensor, to any gateway, and ultimately into clinical workflows world-wide?

Challenge – Need for Scale

The world’s largest technology companies are making great strides in connecting healthcare apps, devices and electronic health information systems but they are all based on proprietary interfaces that must be custom managed company by company by each system integrator. This has allowed each of those companies to move quickly into the healthcare IT space, but it is challenging to reach global scale. System integrators don’t have unlimited resources necessary to integrate hundreds of devices that would happen automatically if manufacturers implemented open standards-based observation uploads in uniform fashion.

Solution – Open Standards and Profiles

Standards may provide connectivity but it is the uniform implementation of these standards that assures interoperability. By their very nature, standards provide some flexibility to encourage general adoption by the industry. It is their common implementation guided by profiles and verified by test that allows any sensor to connect to any device and any health information system.

This uniform implementation guidance is provided by such organizations as Integrating the Healthcare Enterprise. The family of IHE profiles include those that support the upload of observations. The most popular enterprise solution uploads HL7 International V2.6 Observations via the IHE PCD-01 profile using web protocols popular in the last decade. Uploading observations using HL7 FHIR is rapidly gaining popularity as it employs web protocols widely adopted by developers across industries. Implementation guidance is available in the IHE Personal Health Device Observation Upload profile.

The profile used in the second method explains how to employ the HL7 FHIR® standard to upload observations. It describes how to map personal health monitoring data (e.g. temperature, blood oxygen) received from the sensors into FHIR resources. Three resources (Patient, Observation, Device) then form a FHIR data payload that is transported to a health information server via the internet using RESTful style web services and protected using OAuth.

Rapid Integration

Product implementation per these profiles is greatly simplified by a library of commercial ready software.  This dramatically reduces product integration from months to days freeing engineers to focus on applications that provide value add and differentiate their offering in the market. To streamline regulatory approvals, this software is developed in accordance with industry standards IEC 62304 medical device software processes and ISO 13485-based project quality plan.

Open Source Tools

The Personal Connected Health Alliance has available today a home to hospital solution that allows any sensor to connect to any gateway and any clinical health information system to provide a holistic picture of a patient’s well-being without direct contact with their doctor until medical intervention is required for successful outcome.

Engage your engineering and product teams today to learn more about how you can quickly and easily provide remote patient monitoring products to meet the exploding demand for solutions that keep doctors safe and patients empowered.

The next blog in this series describes an interoperability and compliance program complete with the processes, procedures and tools necessary to ensure buyer requirements are clearly communicated and products can demonstrate conformance to required standards essential to interoperability.